Abstract
Purpose:
One of the newest advancements in cataract surgery is the use of femtosecond laser. The percentage of residency programs that have access to the femtosecond laser is not reported, and there is limited data about resident training in femtosecond cataract surgery. The purpose of this cross-sectional study is to determine how ophthalmology residents in the United States are being trained to perform femtosecond laser cataract surgery and identify any barriers to incorporating it in resident curriculum.
Methods:
ACGME-accredited ophthalmology residency programs were mailed a survey inquiring about their access to femtosecond lasers and the role in resident education. Surveys were anonymous and respondent results were tabulated in an excel spreadsheet.
Results:
We had a response rate of 80%. 74% of academic departments did not utilize a femtosecond laser for cataract surgery but 50% planned on obtaining a laser within 5 years. Of those that do utilize a femtosecond laser, 38% had a laser located at the ASC, 33% at a private hospital and 33% at a VA Hospital. The most common type of laser used was the Alcon LenSx followed by the AMO Catalys. 79% residency programs do not train residents to undergo femtolaser cataract surgery, but 55% plan to develop training within 5 years. The most perceived barrier to resident access was cost, followed by laser location and inexperienced attendings. Among the 21% of residency programs that train their residents to perform femtosecond cataract surgery, most of the residents begin preclinical training (55%), observing (43%), and performing (90%) cases during PGY4 level. Of the programs that perform laser cases, 55% of residents perform 1 to 9, 15% perform 10 to 24, and 25% perform between 25-100.
Conclusions:
The majority of academic department do not use femtosecond lasers for cataract surgery and the majority of residency program do not train their residents to use this technology. The largest barrier to resident access is cost. However among academic departments that do not yet have a femtosecond laser, about half of the programs plan on developing hands-on laser access for residents within the next five years. In residencies that do currently teach residents to perform femtosecond cases, most training occurs during their PGY4 year and the majority of residents graduate each with a small total of 1 to 9 cases.